Organization
MIA VITA COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MALLORY R DEVONA LPC (OWNER)
(860) 857-4769
Entity
Organization
Contact information
Practice address
425 DIXWELL AVE, NEW HAVEN, CT 06511-1771
(203) 489-6524
Mailing address
112 GREAT NECK RD, WATERFORD, CT 06385-3504
(860) 857-4769
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/19/2018
Last updated
07/19/2018
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